Thursday, February 12, 2009

Anesthesia Providers, Truth and Informed Consent

Right off the bat many of us have been surprised to learn that nurses are now knocking us out, performing nerve blocks and other things previously done by Doctors. These people are called CRNA's; Certified Registered Nurse Anesthetists. Obviously these people are not doctors no matter how many letters they have following their name. If it doesn't say M.D. they are not trained to the same standard as a Doctor. In fact the law says a couple of things about these CRNA's and their use in the hospital. Pay attention because these laws are also being routinely breached.

CRNA's are required by law to introduce themselves and state their purpose for being in your room. Funny how they never seem to say, "Hi, I'm a nurse and I will be performing your anesthesia today instead of a Doctor!" Mine introduced himself by his first name and insinuated he was a Doctor. This is a big no no. I, quite naturally, would have taken exception to this. I was having a "dangerous" nerve block as explained by my wannabe Doctor, and I have had previous problems with anesthesia agents. I needed a Doctor. The law states that I can request a Doctor, but first you have to be informed that this person is a nurse, not a Doctor, and will be performing the Doctor's job. So we are right back to "informed consent" aren't we?

This bait and switch should be contained in the "informed consent." You have a right to have the CRNA explained to you along with the information that you are not required to have a nurse instead of a Doctor. This is more information that the medical people choose not to reveal. This is our right to know. It's the law. Who will win this battle? It should be patients, not deceptive hospital personnel.

The law also states that the CRNA must be under the supervision of a Doctor. Good luck with that. This is another law that the hospital finds itself unable to comply with. Since hospitals have no fiduciary duty to the patient, what the hell do they care which laws are broken, they are not responsible.

So why is it then that we as patients are not allowed to select our anesthesia provider, just as we selected our surgeon or GP? Can anybody answer that? I didn't even get to speak to mine until show time. The hospital selected this lawless person to administer anesthesia to me without properly informing me of who he was and what he was doing, and yet they have no responsibility for him in the hospital. He is a free agent to obey or not the laws pertaining to his job.

In regard to the expense of CRNA's. The whole concept as near as I can make out was that CRNA's would save money. You can have the little nurse take care of the light weight anesthesia and save the others for a Doctor, who allegedly makes more money. Only problem is, this CRNA person has to be supervised by a Doctor as per the law.

So instead of one person making a 6 figure salary, now you have 2 people making 6 figure salaries. The CRNA (that's right folks nursey poo makes a 6 figure salary) AND the supervising Doctor. Here's where it can get really ticklish, so if you are an ANESTHESIOLOGIST (not a nurse) why don't you set me straight.

The supervising Doctor gets paid for supervising whether he/she actually does or not because that's the law. This has to be on paper at least, even if the Doctor was nowhere near the OR. The Doctor could be "supervising" many CRNA's and getting paid for each one of them whilst he/she (the Doctor) is in the cafeteria. They do bill you for the Doctor AND the CRNA, for the same procedure, get out your billing statement and see. This saves money?

There are a lot of things going on behind the white wall of silence that do not pass the smell test. If these people think that this shabby care can go on, all the while becoming so expensive that only welfare recipients and government employees can afford it think again. Health care is the next bubble to burst as it becomes a luxury few can afford. Unless they start euthanizing all of their "human capital" (you know all those pesky working people who pay all the bills) our politicians are going to HAVE TO PASS LAWS TO ALLEVIATE THIS PROBLEM! THERE IS NO OTHER WAY OUT OF THIS MESS WE CALL HEALTH CARE IN THIS COUNTRY!

Sorry folks, but we cannot have medical people forcing us into expensive, unnecessary treatments, like conscious sedation! We have to have some control over what happens to us in the hospitals and clinics. We need to get control of the people in those hospitals. Medical care has become an orgy of lawbreaking and expense. The first on my wish list is to put restraints on the use of Versed. It's unnecessary for most, unreasonably expensive, and nearly impossible to decline.

No comments:

Post a Comment